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We're here covering such an awful thing, but
this is a really, really touching moment, actually.
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[FOREIGN].
>> Thank you so much for having us here.
>> [FOREIGN].
>> [APPLAUSE].
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We were the first outsiders to visit Beranimbo since the outbreak, and
the villagers were more than ready to share their stories.
[SOUND]
While they prepared the freshly slaughtered zebu, we went to
meet with some of the villagers who'd managed to survived the black plague.
Can you tell me a little bit about when you started to get sick?
>> [FOREIGN_LANGUAGE].
>> Do you feel closer together, now that you've been through this together?
>> [LAUGH]
[FOREIGN_LANGUAGE].
>> We got here about an hour and a half ago, and
the first thing that we saw was they slaughtered the zebu for us, and
now they've prepared a meal, and we're gonna go eat that zebu with the village.
Yeah never had zebu before.
Let's see here, zebu with rice and some green plants, all right.
This is really good, it's pretty good, it's pretty good.
>> It's a little gamey.
We're going now with Dr. Gatson to meet a family where the grandfather in
the family had bubonic plague.
>> Salaam, salaam.
What did it feel like to get the plague?
>> [FOREIGN].
>> How has this outbreak affected the village?
>> [FOREIGN].
>> We wanted to stay longer, but our pilot saw storm clouds rolling in
over the mountains, and told us that a severe storm was about to hit.
If we didn't want to get stuck overnight in the highlands,
we needed to leave immediately.
The villagers were so welcoming it was easy to forget that a few
months earlier Beranimbo had been gripped by a full on plague epidemic.
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It's one thing to have a plague outbreak in an isolated community like Beranimbo,
but if plague were to reach the capital city of Antananarivo,
the results would be catastrophic.
Antananarivo is in shambles.
In 2009, the city was the epicenter of a violent,
some might say French-backed coup that threw the country into absolute chaos.
After the coup, Madagascar was promptly suspended from the African Union, and
immediately lost the majority of its international aid.
The economy spiraled into free fall, and the health standard plummeted.
Today, over 90% of the population lives on less than $2 a day.
The living conditions in the poorest areas of Antananarivo are much
worse than they are in the villages, making the capital city a powder keg.
Before the coup, foreign aid made up 70% of Madagascar's national budget.
Now without that money,
the country's in no position to defend itself against the plague outbreak.
This fact became clearer when I spoke with Dr.
Jean Louis Robinson, the former Health Minister who was ousted during the coup.
>> Hi. >> Hello.
>> How are you?
>> Hello, nice to meet you.
>> Nice to meet you.
>> What kind of effect did the coup have on public health in this country?
>> [FOREIGN].
On our way out, we saw some evidence of this anarchy right outside Dr.
Robinson's compound.
He's extremely wealthy.
He's one of the 8% of this country that lives on more than $2 a day, and yet
still, just outside the gates, there's just all of this garbage.
We wanted to see how vulnerable the poorest areas of Antananarivo were to
an outbreak of black plague, so we traveled to Andavamamba,
a deep slum whose name translates to the crocodile hole.
>> If there is a case of pneumonic plague in the slum,
there will be dozens, hundreds, or thousands of cases.
For me it's the main risk.
Plague is a bacterial disease.
But it's also a social disease.
>> There's a number of factors here that contribute to it being pretty vulnerable
for the plague.
There's an open sewer system, garbage pileup,
a lack of access to clean water, dilapidated mud houses, rats, and
just a general level of filth surrounding the entire landscape.
It's basically medieval, especially when you start to consider that we're so
close to farms, and people are living so close to one another.
So, today we're gonna meet up with a guy name Billo who lives here and
he's gonna give us a guided tour, and show us why this area is so at risk for
an outbreak of plague.
So, this pretty much just looks like an open sewer here, is that right?
>> [FOREIGN].
>> Would you say things have gotten
worse since the 2009 coup?
>> [FOREIGN].
>> Are you scared of a plague outbreak happening here?
>> [FOREIGN].
>> The thing is, if there were to be an outbreak in the capital,
Malagasy doctors probably wouldn't be much help.
When poor people go to clinics, they're often rejected.
And many doctors are too scared to treat the black plague.
Some misdiagnose it completely.
This creates a culture where the poorest people in the country have zero ability to
protect themselves.
The fact made infinitely more depressing when you consider the black plague is
treatable with cheap antibiotics.
>> Two pneumonic cases arrived in a big hospital of Antananarivo,
and at each time it was very difficult for the medical staff to manage it.
We have seen that physicians or nurses prefer to dismiss than to treat people,
there was some panic in fact, in the medical staff to do things appropriately.
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>> In December 2013, Madagascar had a democratic election.
And now foreign aid has begun to trickle back into the country.
But it's an open question whether or
not that aid will get to those who need it most in time.
There is an urgent need for funding the control of this neglected disease.
And it is a neglected disease in neglected areas, where no politicians are going.
Where no physicians want to go, because it's too remote.
A neglected disease in a neglected area is very dangerous for the population.
But, because people are moving, in fact, it is dangerous for everybody.
>> The reality is that this is exactly how the Ebola virus spread
throughout West Africa.
Belief in old practices, rampant misinformation, and
apathetic, corrupt politicians have combined to
make the current outbreak much more widespread than it should be.
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For Madagascar though,
it's unknown how many people will die of plague before things start to change.
There's no easy answer, but it's clear that the cutting of
international aid has encouraged the spread of the disease.
On the one hand, first world creditor nations should set standards, and
deny aid to regimes that undermine democracy.
From the other, there's a human cost to cutting that aid.
And in Madagascar's case, it's the revival of a medieval disease.
We're not in the Middle Ages anymore.
Every death from this disease is entirely preventable.
Which makes the horror, much more cutting.
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[LAUGH]